Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | NY3728 | NY |
N | 156FC0801X | Contact Lens Fitter | NY3728 | NY |
N | 156FX1800X | Optician | NY3728 | NY |
NPI | 1578687364 |
---|---|
Provider Name | Mr. Dennis M Bunz |
First Address | Cheektowaga, NY 14225-5040 |
Second Address | Cheektowaga, NY 14225-5040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2007 |
Last Update Date | 10/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00622082 | (05) | NY |